lumbosacral transitional vertebrae
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2021 ◽  
pp. rapm-2021-103174
Author(s):  
Bart Liebrand ◽  
Koen Brakel ◽  
Arthur Boon ◽  
Walter van der Weegen ◽  
Selina van der Wal ◽  
...  

BackgroundLumbosacral transitional vertebra can result in an anomalous number of lumbar vertebrae associated with wrong level treatment. The primary aim of this study was to characterize discrepancies between reported referring levels and levels from MRI reports with treated levels. The secondary aim was to analyze interobserver variability between a pain physician and a radiologist when determining levels and classifying lumbosacral transitional vertebrae.MethodsBetween February 2016 and October 2019, a retrospective case series of prospectively collected data of the affected levels mentioned in referrals, MRI reports and treated levels was performed. The counting process, level determination, classification of lumbosacral transitional vertebrae and a secondary control were carried out by independent researchers using a standard methodology.ResultsOf the 2443 referrals, 143 patients had an anomalous number of lumbar vertebrae; of these, 114 were included for analysis. The vertebral level noted in the patient’s file, in the referral, and the reported level of treatment differed in 40% of these cases. The vertebral level between the MRI reports and treatment differed in 46% of cases. The interobserver reliability (radiologist vs pain physician) for classifying a transitional vertebra was fair ((κ=0.40) and was substantial (κ=0.70) when counting the vertebrae.ConclusionIn the presence of lumbar spine anomalies, we report a high prevalence of discrepancies between referral levels and MRI pathological findings with treatment levels. Further research is needed to better understand clinical implications.


2021 ◽  
Vol 6 (2) ◽  
pp. 1507-1511
Author(s):  
Sanzida Khatun ◽  
Diwakar Kumar Shah

Introduction: Lumbosacral Transitional vertebrae are congenital anomalies of lumbosacral vertebral junction. It may present either as sacralization of fifth lumbar vertebrae or lumbarization of first sacral vertebrae. Various secondary pathological spinal conditions such as intervertebral disc herniation and/or degeneration, facet joint arthrosis and spinal canal or foraminal stenosis are associated with the presence of LSTV. The failure in the identification may lead to clinical consequences such as errors in diagnosis of disease and lumbosacral procedures. Objective: The aim of this study was to determine the prevalence and patterns of LSTV in patients presenting to Department of Radiology of Nobel Medical College Teaching Hospital, Nepal.. Methodology: A descriptive cross-sectional study was conducted in Department of Radiology of Nobel Medical College Teaching Hospital, Nepal.Plain radiographs including Antero-posterior (AP) and Lateral views of lumbosacral spine of 343 patients referred for the scan were analyzed for the presence of lumbosacral vertebrae. Result: Out of 343 patients, LSTV was found in 61 (17.8%) subjects. Thirty-eight subjects (11.1%) exhibited sacralization and 23 (6.7%) showed lumbarization.Out of total LSTV subjects,  type I A was present in 8 (13.1%), type I B in 21 (34.4%), type II A in 10 (16.4%), type II B in 5 (8.2%) , type III A in 6 (9.8%) , type III B in 9 (14.8%) and type IV in 2 (3.3%). Conclusion: The LSTV is prevalent in almostone-fifth of subjects presenting to department of radiology of Nobel Medical College and Teaching Hospital, Biratnagar for lumbosacral scan.. Sacralization occurs more frequently than lumbarization, both of which alter the morphology of anatomical structures in spine. The presence of anomaly in this region may be related to occurrence of various pathological and clinical conditions.


2021 ◽  
Vol 12 ◽  
pp. 516
Author(s):  
Sarah Kawtharani ◽  
Shadi Abdelatif Bsat ◽  
Mohamad El Housheimy ◽  
Charbel Moussalem ◽  
Adham Halaoui ◽  
...  

Background: Bertolotti’s syndrome (i.e., varying extent of fusion between the last lumbar vertebra and the first sacral segment) or lumbosacral transitional vertebrae is a rare cause of back pain. Notably, this syndrome is one of the differential diagnoses for patients with refractory back pain/sciatica. Case Description: A 71-year-old male presented with low back pain of 3 years duration that radiated into the right lower extremity resulting in numbness in the L5 distribution. He then underwent a minimally invasive approach to resect the L5 “wide” transverse process following the CT diagnosis of Bertolotti’s syndrome. Prior to surgery, patient reported pain that was exacerbated by ambulation that resolved post-operative. Conclusion: Bertolotti’s syndrome is one of the rare causes of sciatica that often goes undiagnosed. Nevertheless, it should be ruled out for patients with back pain without disc herniations or other focal pathology diagnosed on lumbar MR scans.


Spine ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Jaakko Hanhivaara ◽  
Juhani H. Määttä ◽  
Jaro Karppinen ◽  
Jaakko Niinimäki ◽  
Mika T. Nevalainen

Animals ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 2482
Author(s):  
Petra Černá ◽  
Joep Timmermans ◽  
Dominik Komenda ◽  
Ivana Nývltová ◽  
Pavel Proks

(1) Background: The aim of this study was to find the prevalence of feline hip dysplasia (HD), patellar luxation and lumbosacral transitional vertebra (LTV) in pedigree cats in the Czech Republic. (2) Methods: 107 pedigree cats at least 10 months old were recruited prospectively at the Small Animal Clinic at the University of Veterinary and Pharmaceutical Sciences Brno, CZ, between April 2019 and July 2020. (3) Results: The prevalence of hip joint dysplasia in all pedigree cats was 46.7%, of which 78% of cats had bilateral dysplasia. The HD was mainly from mild (grade 1) to moderate (grade 2); however, 6.1% of hip joints showed signs of severe HD (grade 3) in Maine Coon and Siberian cats. Patellar luxation was noted in 32.7% of the pedigree cats, was present bilaterally in 91.4% and was grade 1 or 2 in most cats. The presence of LTV was noted in 7.5% of pedigree cats. (4) Conclusions: The high prevalence of HD in pedigree cats should be considered and screening pedigree cats for HD is recommended before they are used in breeding programs.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Yong Huang ◽  
Lu Mao ◽  
Hang Shi ◽  
Guanrui Ren ◽  
Lei Zhu ◽  
...  

Objective. To investigate whether lumbosacral transitional vertebrae (LSTV) affects the clinical outcomes of percutaneous endoscopic lumbar discectomy (PELD) in adolescent patients with lumbar disc herniation (LDH). Methods. This was a retrospective study with two groups. Group A was made up of 22 adolescent LDH patients with LSTV (18 males and 4 females). Group B was made up of 44 adolescent LDH patients without LSTV (36 males and 4 females), who were matched to group A for age, sex, and body mass index. All patients underwent PELD at the L4/5 or L5/S1 single level and were followed up at 18 months after surgery. We identified LSTV on radiographs and computed tomography and assessed the imaging characteristics of all patients. Outcomes were evaluated through a numerical rating scale (NRS), the Oswestry Disability Index (ODI), the modified MacNab grading system, and the incidence of additional lumbar surgery. Results. At 18 months after PELD, both groups had significant improvements in the mean NRS scores of low back pain (LBP) or leg pain and the ODI scores. In terms of the MacNab criteria, 90.9% in group A and 93.2% in group B showed excellent or good outcomes. The mean NRS scores of LBP or leg pain, ODI score, and MacNab grade after surgery were not significantly different between the 2 groups. Two patients (one patient had a recurrence; one patient had a new lumbar disc herniation) in group A and 3 patients (one patient had a recurrence; two patients had new lumbar disc herniations) in group B underwent additional lumbar surgery. Conclusions. Our study suggests that in terms of pain relief, life function improvement, and the incidence of additional lumbar surgery, LSTV has no effect on the short-term clinical outcomes of PELD in adolescents. A new lumbar disc herniation is an important reason for additional surgery in adolescents, regardless of the LSTV status.


2021 ◽  
Vol 103-B (7) ◽  
pp. 1301-1308
Author(s):  
Kosuke Sugiura ◽  
Masatoshi Morimoto ◽  
Kosaku Higashino ◽  
Makoto Takeuchi ◽  
Akihiro Manabe ◽  
...  

Aims Although lumbosacral transitional vertebrae (LSTV) are well-documented, few large-scale studies have investigated thoracolumbar transitional vertebrae (TLTV) and spinal numerical variants. This study sought to establish the prevalence of numerical variants and to evaluate their relationship with clinical problems. Methods A total of 1,179 patients who had undergone thoracic, abdominal, and pelvic CT scanning were divided into groups according to the number of thoracic and lumbar vertebrae, and the presence or absence of TLTV or LSTV. The prevalence of spinal anomalies was noted. The relationship of spinal anomalies to clinical symptoms (low back pain, Japanese Orthopaedic Association score, Roland-Morris Disability Questionnaire) and degenerative spondylolisthesis (DS) was also investigated. Results Normal vertebral morphology (12 thoracic and five lumbar vertebrae without TLTV and LSTV) was present in 531 male (76.7%) and 369 female patients (75.8%). Thoracolumbar transitional vertebrae were present in 15.8% of males and 16.0% of females. LSTV were present in 7.1% of males and 9.0% of females. The prevalence of the anomaly of 16 presacral mobile vertebrae (total number of thoracolumbar vertebrae and TLTV) without LSTV was 1.0% in males and 4.1% in females, and that of the anomaly of 18 vertebrae without LSTV was 5.3% in males and 1.2% in females. The prevalence of DS was significantly higher in females with a total of 16 vertebrae than in those with normal morphology. There was no significant correlation between a spinal anomaly and clinical symptoms. Conclusion Overall, 24% of subjects had anomalies in the thoracolumbar region: the type of anomaly differed between males and females, which could have significant implications for spinal surgery. A decreased number of vertebrae was associated with DS: numerical variants may potentially be a clinical problem. Cite this article: Bone Joint J 2021;103-B(7):1301–1308.


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